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Mental nerve paresthesia secondary to initiation of endodontic therapy: a case report.

Andrabi SM, Alam S, Zia A, Khan MH, Kumar A - Restor Dent Endod (2014)

Bottom Line: Acute periapical infection in mandibular posterior teeth may also sometimes disturb the normal functioning of the inferior alveolar nerve.Altered sensation and pain in the involved areas may interfere with speaking, eating, drinking, shaving, tooth brushing and other events of social interaction which will have a disturbing impact on the patient.Permanent paresthesia is the result of nerve trunk laceration or actual total nerve damage.

View Article: PubMed Central - PubMed

Affiliation: Department of Conservative Dentistry, Dr. Z. A. Dental College, Aligarh Muslim University, Aligarh, India.

ABSTRACT
Whenever endodontic therapy is performed on mandibular posterior teeth, damage to the inferior alveolar nerve or any of its branches is possible. Acute periapical infection in mandibular posterior teeth may also sometimes disturb the normal functioning of the inferior alveolar nerve. The most common clinical manifestation of these insults is the paresthesia of the inferior alveolar nerve or mental nerve paresthesia. Paresthesia usually manifests as burning, prickling, tingling, numbness, itching or any deviation from normal sensation. Altered sensation and pain in the involved areas may interfere with speaking, eating, drinking, shaving, tooth brushing and other events of social interaction which will have a disturbing impact on the patient. Paresthesia can be short term, long term or even permanent. The duration of the paresthesia depends upon the extent of the nerve damage or persistence of the etiology. Permanent paresthesia is the result of nerve trunk laceration or actual total nerve damage. Paresthesia must be treated as soon as diagnosed to have better treatment outcomes. The present paper describes a case of mental nerve paresthesia arising after the start of the endodontic therapy in left mandibular first molar which was managed successfully by conservative treatment.

No MeSH data available.


Related in: MedlinePlus

(a) Master cone radiograph; (b) Post-obturation radiograph.
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Figure 5: (a) Master cone radiograph; (b) Post-obturation radiograph.

Mentions: The patient was recalled after one week. Although the tooth had become asymptomatic, the feeling of numbness was still there. No intervention was done at this appointment and the patient was asked to continue methylcobalamin supplement and report after three weeks. The patient reported after three weeks with remarkable improvement in the feeling of paresthesia. The area of numbness was now reduced and was confined to the left lower lip region (Figure 3). The tooth was not tender on percussion or palpation but the obturation was still deferred to wait for the paresthesia to reduce further or to disappear completely. Two weeks later (i.e. 6 weeks after the initial visit) the paresthesia had mostly disappeared except for a small patch inside the left lower lip (Figure 4). The tooth was completely asymptomatic and therefore obturation was performed at this visit with laterally condensed gutta-percha and a zinc oxide eugenol based sealer (Figures 5a and 5b). The patient was seen again at 10 weeks from the initial visit as the symptoms of paresthesia had then subsided completely, and the patient was scheduled for restoration of the tooth. The tooth was restored with porcelain fused to metal full crown (Figure 6a). The tooth stays in function 1 year post-operatively with the area of paresthesia returned to normal sensation (Figure 6b).


Mental nerve paresthesia secondary to initiation of endodontic therapy: a case report.

Andrabi SM, Alam S, Zia A, Khan MH, Kumar A - Restor Dent Endod (2014)

(a) Master cone radiograph; (b) Post-obturation radiograph.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4125586&req=5

Figure 5: (a) Master cone radiograph; (b) Post-obturation radiograph.
Mentions: The patient was recalled after one week. Although the tooth had become asymptomatic, the feeling of numbness was still there. No intervention was done at this appointment and the patient was asked to continue methylcobalamin supplement and report after three weeks. The patient reported after three weeks with remarkable improvement in the feeling of paresthesia. The area of numbness was now reduced and was confined to the left lower lip region (Figure 3). The tooth was not tender on percussion or palpation but the obturation was still deferred to wait for the paresthesia to reduce further or to disappear completely. Two weeks later (i.e. 6 weeks after the initial visit) the paresthesia had mostly disappeared except for a small patch inside the left lower lip (Figure 4). The tooth was completely asymptomatic and therefore obturation was performed at this visit with laterally condensed gutta-percha and a zinc oxide eugenol based sealer (Figures 5a and 5b). The patient was seen again at 10 weeks from the initial visit as the symptoms of paresthesia had then subsided completely, and the patient was scheduled for restoration of the tooth. The tooth was restored with porcelain fused to metal full crown (Figure 6a). The tooth stays in function 1 year post-operatively with the area of paresthesia returned to normal sensation (Figure 6b).

Bottom Line: Acute periapical infection in mandibular posterior teeth may also sometimes disturb the normal functioning of the inferior alveolar nerve.Altered sensation and pain in the involved areas may interfere with speaking, eating, drinking, shaving, tooth brushing and other events of social interaction which will have a disturbing impact on the patient.Permanent paresthesia is the result of nerve trunk laceration or actual total nerve damage.

View Article: PubMed Central - PubMed

Affiliation: Department of Conservative Dentistry, Dr. Z. A. Dental College, Aligarh Muslim University, Aligarh, India.

ABSTRACT
Whenever endodontic therapy is performed on mandibular posterior teeth, damage to the inferior alveolar nerve or any of its branches is possible. Acute periapical infection in mandibular posterior teeth may also sometimes disturb the normal functioning of the inferior alveolar nerve. The most common clinical manifestation of these insults is the paresthesia of the inferior alveolar nerve or mental nerve paresthesia. Paresthesia usually manifests as burning, prickling, tingling, numbness, itching or any deviation from normal sensation. Altered sensation and pain in the involved areas may interfere with speaking, eating, drinking, shaving, tooth brushing and other events of social interaction which will have a disturbing impact on the patient. Paresthesia can be short term, long term or even permanent. The duration of the paresthesia depends upon the extent of the nerve damage or persistence of the etiology. Permanent paresthesia is the result of nerve trunk laceration or actual total nerve damage. Paresthesia must be treated as soon as diagnosed to have better treatment outcomes. The present paper describes a case of mental nerve paresthesia arising after the start of the endodontic therapy in left mandibular first molar which was managed successfully by conservative treatment.

No MeSH data available.


Related in: MedlinePlus